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Factors Associated with the Refusal of Direct-Acting Antiviral Agents for the Treatment of Hepatitis C in Taiwan

Background and Objectives: Direct-acting antiviral agents (DAA) are a safe and highly effective treatment for hepatitis C virus (HCV) infection. However, the uptake of DAA treatment remains a challenge. This study aims to examine the reasons for DAA refusal among HCV patients covered by the Taiwan N...

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Autores principales: Chang, Li-Jen, Chang, Han-Cheng, Chen, Po-Yueh, Chen, Chi-Yi, Tsai, Kun-Feng, Yean, Koh-Kok, Yang, Hsin-Yi, Chen, Tsung-Hsien, Yu, Pao-Ta, Chou, Chu-Kuang, Chen, Sheng-Hsuan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031294/
https://www.ncbi.nlm.nih.gov/pubmed/35454360
http://dx.doi.org/10.3390/medicina58040521
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author Chang, Li-Jen
Chang, Han-Cheng
Chen, Po-Yueh
Chen, Chi-Yi
Tsai, Kun-Feng
Yean, Koh-Kok
Yang, Hsin-Yi
Chen, Tsung-Hsien
Yu, Pao-Ta
Chou, Chu-Kuang
Chen, Sheng-Hsuan
author_facet Chang, Li-Jen
Chang, Han-Cheng
Chen, Po-Yueh
Chen, Chi-Yi
Tsai, Kun-Feng
Yean, Koh-Kok
Yang, Hsin-Yi
Chen, Tsung-Hsien
Yu, Pao-Ta
Chou, Chu-Kuang
Chen, Sheng-Hsuan
author_sort Chang, Li-Jen
collection PubMed
description Background and Objectives: Direct-acting antiviral agents (DAA) are a safe and highly effective treatment for hepatitis C virus (HCV) infection. However, the uptake of DAA treatment remains a challenge. This study aims to examine the reasons for DAA refusal among HCV patients covered by the Taiwan National Health Insurance system. Materials and Methods: This retrospective observational study covered the period from January 2009 to December 2019 and was conducted at a single hepatitis treatment center in Taiwan. This study involved chart reviews and phone-based surveys to confirm treatment status and refusal causes. To confirm treatment status, subjects with HCV without treatment records were phone-contacted to confirm treatment status. Patients who did not receive treatment were invited back for treatment. If the patient refused, the reason for refusal was discussed. Results: A total of 3566 patients were confirmed with DAA treatment; 418 patients (179 patients who were lost to contact or refused the survey and 239 patients who completed the survey of DAA refusal) were included in the no-DAA-therapy group. Factors associated with receiving DAAs were hemoglobin levels, hepatitis B virus co-infection, and regular gastroenterology visits. Meanwhile, male sex, platelet levels, and primary care physician visits were associated with DAA refusal. The leading causes of treatment refusal were multiple comorbidities, low health literacy, restricted access to hospitals, nursing home residence, and old age. The rate of DAA refusal remains high (10%). Conclusions: The reasons for treatment refusal are multifactorial, and addressing them requires complex interventions.
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spelling pubmed-90312942022-04-23 Factors Associated with the Refusal of Direct-Acting Antiviral Agents for the Treatment of Hepatitis C in Taiwan Chang, Li-Jen Chang, Han-Cheng Chen, Po-Yueh Chen, Chi-Yi Tsai, Kun-Feng Yean, Koh-Kok Yang, Hsin-Yi Chen, Tsung-Hsien Yu, Pao-Ta Chou, Chu-Kuang Chen, Sheng-Hsuan Medicina (Kaunas) Article Background and Objectives: Direct-acting antiviral agents (DAA) are a safe and highly effective treatment for hepatitis C virus (HCV) infection. However, the uptake of DAA treatment remains a challenge. This study aims to examine the reasons for DAA refusal among HCV patients covered by the Taiwan National Health Insurance system. Materials and Methods: This retrospective observational study covered the period from January 2009 to December 2019 and was conducted at a single hepatitis treatment center in Taiwan. This study involved chart reviews and phone-based surveys to confirm treatment status and refusal causes. To confirm treatment status, subjects with HCV without treatment records were phone-contacted to confirm treatment status. Patients who did not receive treatment were invited back for treatment. If the patient refused, the reason for refusal was discussed. Results: A total of 3566 patients were confirmed with DAA treatment; 418 patients (179 patients who were lost to contact or refused the survey and 239 patients who completed the survey of DAA refusal) were included in the no-DAA-therapy group. Factors associated with receiving DAAs were hemoglobin levels, hepatitis B virus co-infection, and regular gastroenterology visits. Meanwhile, male sex, platelet levels, and primary care physician visits were associated with DAA refusal. The leading causes of treatment refusal were multiple comorbidities, low health literacy, restricted access to hospitals, nursing home residence, and old age. The rate of DAA refusal remains high (10%). Conclusions: The reasons for treatment refusal are multifactorial, and addressing them requires complex interventions. MDPI 2022-04-07 /pmc/articles/PMC9031294/ /pubmed/35454360 http://dx.doi.org/10.3390/medicina58040521 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chang, Li-Jen
Chang, Han-Cheng
Chen, Po-Yueh
Chen, Chi-Yi
Tsai, Kun-Feng
Yean, Koh-Kok
Yang, Hsin-Yi
Chen, Tsung-Hsien
Yu, Pao-Ta
Chou, Chu-Kuang
Chen, Sheng-Hsuan
Factors Associated with the Refusal of Direct-Acting Antiviral Agents for the Treatment of Hepatitis C in Taiwan
title Factors Associated with the Refusal of Direct-Acting Antiviral Agents for the Treatment of Hepatitis C in Taiwan
title_full Factors Associated with the Refusal of Direct-Acting Antiviral Agents for the Treatment of Hepatitis C in Taiwan
title_fullStr Factors Associated with the Refusal of Direct-Acting Antiviral Agents for the Treatment of Hepatitis C in Taiwan
title_full_unstemmed Factors Associated with the Refusal of Direct-Acting Antiviral Agents for the Treatment of Hepatitis C in Taiwan
title_short Factors Associated with the Refusal of Direct-Acting Antiviral Agents for the Treatment of Hepatitis C in Taiwan
title_sort factors associated with the refusal of direct-acting antiviral agents for the treatment of hepatitis c in taiwan
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031294/
https://www.ncbi.nlm.nih.gov/pubmed/35454360
http://dx.doi.org/10.3390/medicina58040521
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